'Intelligent discontent is the mainspring of civilization.' -- Eugene V. Debs

Tuesday, August 18, 2009

The Death of Health Care Reform in Real Time (Part 2) 

The blog has been quiescent because of my brief family vacation and pressing work demands, but now, I am back in action. Last Saturday, I discovered, yet again, that the Davis Farmers Market is one of those places where important political transformations first make themselves known.

As I walked through the market with my son, I passed by a table in the community activity section beyond the produce area. There were people sitting in chairs under an awning that announced www.barackobama.com and urged support for health insurance reform. Upon my return passage back through the market towards my car, I looked at the awning again, and recognized its significance. Obama had abandoned the more audacious goal of health care reform and replaced it with a more subdued one, health insurance reform.

In other words, the urgency of providing competitive, cost-efficient health coverage to almost everyone had been replaced by the more prosaic aspiration of humanizing the means by which insurers provide health insurance coverage. My suspicion was confirmed an hour or so later when one of my friends told me that he had actually read the petition at the table and recognized that there was no reference to a public option for health care. He told the people at the table that he would sign a petition that demanded a public option to contain costs, and was curtly told that he could start his own petition.

As you might have guessed from this exchange, the people at the table displayed none of the warmth and enthusiasm of the grassroots effort associated with the Obama presidential campaign. Instead, they looked like Young Democrats from UC Davis just down the street, you know, college student careerists working to curry favor with local Democratic elected officials in the hope that they will be hired for positions as administrative assistants. Clearly, this was an effort coordinated by the White House, through the perverse remains of the Obama Internet campaign apparatus, for outreach into communities across the country.

On Sunday, Health and Human Services Secretary Kathryn Sibelius formally announced the shift in policy when she declared that Obama did not consider the public option as an essential, non-negotiable component of a health care reform proposal. Of course, no one should be surprised. White House Chief of Staff Rahm Emanuel has not concealed his hostility to the public option and its proponents, and the President has observed a strict silence on the subject. Liberals, however, were outraged. There are supposedly as many as 100 House Democrats that will refuse to vote out a health care bill that does not include a public option. I'll believe it when I see it. At the end of the day, we will probably see the inclusion of a public option into the bill that will benefit few, if any, people. One of those chimerical exercises reminscent of the rights enumerated in Stalinist constitutions.

Such a depressing state of affairs raises the question: how did we get to a point where a health care proposal with substantial public support degenerated into yet another corporate windfall? To confront this question, we call upon our powers of random observation. First, it is quite striking that the opponents of health care reform have undermined public confidence by projecting the gross deficiencies of the current system upon the reforms proposed in Congress, most particularly, the public option. The extent of public denial about this is frankly quite shocking. I have pondered why this strategy has been so effective in the face of the known inadequacies of the current health care system.

I have only one, rather elliptical answer. Several years ago, I recall speaking briefly with a friend about investment strategies. One of the things he told me was that Vanguard, the mutual fund company, had a fund that invested exclusively in health care stocks, and that the returns were incredible. Hence, I have a hypothesis that people within the middle and upper middle class that rely upon investment returns only want a health care proposal that enhances the profitability of pharmaceutical companies and providers of health insurance and health care.

Accordingly, they are ecstatic about provisions that require everyone to purchase health insurance, or face the prospect of being fined, while they are hostile to the notion of cost containment through a public option. The essential principle here is that, behind the evil trinity of pharmaceutical companies, health insurance companies and health care providers, are millions of well educated, politically involved people who invest in them. They share the economic perspective of these companies, and advocate in support of them.

Second, the strident protests against health care reform that have taken place at congressional town hall meetings around the country are not well understood. Naturally, they have been financed by industry lobbyists, but this misses their more profound importance. For Obama, they have been a godsend, because they actually enhance the prospects of a corporate friendly reform package being passed. How? Through their excesses, the protesters discredit the opposition against any reform being passed, even as they drown out progressive voices for reforms that actually address the compelling health needs of the populace.

Lastly, we should consider how this episode confirms my evaluation of Obama from last summer:

Obama has been moving towards what some call the center in US politics, if he wasn't there already. And that is actually a little deceptive. He hasn't been moving towards the political center, because that is a dubious form of analysis based upon the acceptance of an unsubstantiated linear, horizontal spectrum that classifies the political values of the US electorate. Instead, as I said here about a month ago, he has been signalling his acceptability to the corporate media, the media that frames the presentation of political subjects to the general public, by adopting conventional narratives on an array of issues, ranging from the war in Iraq to faith based initiatives to the purported failure of black men to fulfill their responsibilities to their families.

Cultural leftists might find a peculiar reassurance in all this, because, if one perceives his actions in this way, Obama is revealing a sophisticated sociological recognition of the power of the media to manufacture consent. In other words, like many cultural leftists, he understands that the US is not an actual, functioning republic where an informed populace selects representatives to implement their preferred policies, and must navigate his way through this system of social control. Implicit in this analysis is a subjective belief that, once elected, he will put this insight to use to reform US politics at home and abroad.

Or, to clarify the concept, Obama understands that the United States is not a functioning democracy, but one dominated by powerful international capital interests that must be assauged if one is to retain power. Therefore, health care reform can only be implemented in a form that meets with their approval, much as the response to the global recession did.

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